, Final Pediatrics 2024 FNP
1. A 3-year-old child has just completed a 7-day course of amoxicillin for a second fe-
brile urinary tract infection and currently has a negative urine culture. What is the next
course of action?
Or
A 1.5 year old child has just completed a 7-day course of amoxicillin for a first febrile
urinary tract infection and currently has a negative urine culture. What is the next
course of action?
ANS - a. Obtain a renal and bladder ultrasound.
1. A 10-year-old child has had abdominal pain for 2 days, which began in the periumbil-
ical area and then localized to the right lower quadrant. The child vomited once today
and then experienced relief from pain followed by an increased fever. What is the likely di-
agnosis?
ANS - a. Appendicitis with perforation
1. A 10-year-old is hit in the head with a baseball during practice and is diagnosed
with concussion, even though no loss of consciousness occurred. The primary care pedi-
atric nurse practitioner is evaluating the child 2 weeks after the injury and learns that the
child is still experiencing some sleepiness every day. The neurological exam is normal.
The child and the parent are adamant that the child be allowed to return to play baseball.
What will the nurse practitioner recommend?
ANS- b. Continuation of physical and cognitive rest
1. A 12-year-old child has a recent history of increased thirst and frequent urination. The
child's weight has been in the 95th percentile for several years. A dipstick UA is positive
for glucose, and random plasma glucose is 350 mg/dL. Which test will the primary care pe-
diatric nurse practitioner order to determine the type of diabetes in this child?
ANS - c. Pancreatic autoantibodies
1. A 12-year-old child whose weight and body mass index (BMI) are in the 75th percen-
tile has a diastolic blood pressure that is between the 95th and 99th percentiles for age,
sex, and height on three separate occasions. Which test will be prescribed for this child ini-
tially?
ANS - c. renal function
1. The primary care pediatric nurse practitioner evaluates a child who awoke with a sore
throat and high fever after a nap. The child appears anxious and is sitting on the parent’s
lap with the neck hyperextended. The physical exam reveals stridor, drooling, nasal flar-
ing, and retractions. What will the nurse practitioner do next?
ANS - d. Transport the child to the hospital via emergency medical services.
1. A 16-year-old adolescent female whose body mass index (BMI) is at the 90th percen-
tile reports irregular periods. The primary care pediatric nurse practitioner notes wide-
spread acne on her face and back and an abnormal distribution of facial hair. The nurse
practitioner will evaluate her further based on a suspicion of which diagnosis?
ANS - d. Polycystic ovary syndrome
1. The primary care pediatric nurse practitioner provides primary care for a 4-month-old in-
fant who has a ventricular septal defect (VSD). The infant has been breastfeeding well
but in the past month has dropped from the 20th percentile to the 5th for weight. What
will the nurse practitioner recommend?
ANS - b. Fortifying breast milk to increase the number of calories per ounce
A 3-month-old infant who was previously healthy now has a persistent cough, bilateral lung
crackles, and poor appetite. The primary care pediatric nurse practitioner auscultates a
grade III/VI, low-pitched, holosystolic murmur over the left lower sternal border and pal-
pates the liver at one centimeter below the ribs. What diagnosis is likely?
ANS - d. Ventricular septal defect (VSD)
, 1. The pediatric nurse practitioner provides primary care for a 5-year-old child diagnosed
with cerebral palsy who exhibits athetosis and poor weight gain in spite of receiving high-
calorie formula to supplement intake. The child has had several episodes of pneumonia in
the past year. Which specialty consultation is a priority for this child?
ANS- d. Surgery for possible fundoplication and gastrostomy
The primary care pediatric nurse practitioner is examining a young child who has cerebral
palsy. Which part of the family history raises concerns about potential child maltreatment?
ANS- b. Limited financial resources
Because of their inability to ambulate, children with cerebral palsy should be evaluated for
which nutrients?
ANS- a. Calcium and vitamin D
A child with cerebral palsy receives all nutrition via gastrostomy tube. What will the pri-
mary care pediatric nurse practitioner recommend to promote dental health in this child?
ANS - b. Daily chlorhexidine gluconate rinses
1. A 2-year-old child who has sickle cell anemia (SCA) comes to the clinic with a cough
and a fever of 101.5°C. The child currently takes penicillin V prophylaxis 125 mg orally
twice daily. What will the primary care pediatric nurse practitioner do?
ANS- a. Admit the child to the hospital to evaluate for sepsis.
1. When performing a neurologic exam to assess for meningeal signs in an infant, the
primary care pediatric nurse practitioner will attempt to elicit the Kernig sign by imple-
menting what action?
ANS - b. extending the leg at the knee with the infant supine.
When performing a neurologic exam to assess for meningeal signs in an infant, the pri-
mary care pediatric nurse practitioner will attempt to elicit the Brudzinki sign by imple-
menting what action?
ANS- c. flexing the infant's neck to touch chin to chest.
1. 5 year old child is diagnoses with Atypical Pneumonia and will be treated as an out-
patient. Which antibiotic will the primary care pediatric nurse practitioner prescribe?
ANS- b. Azithromycin
1. The primary care pediatric nurse practitioner (PNP) is examining a 2-week-old infant
and auscultates a wide splitting of S during expiration. What condition may this find-
ing represent?
ANS - a. Atrial septal defect (ASD)
1. A 3-year-old child has had one episode of acute otitis media (AOM) 3 weeks prior
with a normal tympanogram just after treatment with amoxicillin. In the clinic today, the
child has a type B tympanogram, a temperature of 102.5°F, and a bulging tympanic mem-
brane. What will the primary care pediatric nurse practitioner order?
ANS - c. Amoxicillin-clavulanate twice daily
A child who was treated with amoxicillin and then amoxicillin-clavulanate for acute otitis
media (OTM) is seen for follow-up. The primary care pediatric nurse practitioner notes
dull-gray tympanic membranes with a visible air-fluid level. The child is afebrile and without
pain. What is the next course of action?
ANS- c. Monitoring ear fluid levels for 3 months
1. A child is diagnosed with tinea versicolor. What is the correct management of this dis-
order?
a. Application of selenium sulfide 2.5% lotion twice weekly for 2 to 4 weeks
1. A 3-year-old child is brought to the clinic by a parent who reports that the child refuses
to use the right arm after being swung by both arms while playing. The child is sitting with
1. A 3-year-old child has just completed a 7-day course of amoxicillin for a second fe-
brile urinary tract infection and currently has a negative urine culture. What is the next
course of action?
Or
A 1.5 year old child has just completed a 7-day course of amoxicillin for a first febrile
urinary tract infection and currently has a negative urine culture. What is the next
course of action?
ANS - a. Obtain a renal and bladder ultrasound.
1. A 10-year-old child has had abdominal pain for 2 days, which began in the periumbil-
ical area and then localized to the right lower quadrant. The child vomited once today
and then experienced relief from pain followed by an increased fever. What is the likely di-
agnosis?
ANS - a. Appendicitis with perforation
1. A 10-year-old is hit in the head with a baseball during practice and is diagnosed
with concussion, even though no loss of consciousness occurred. The primary care pedi-
atric nurse practitioner is evaluating the child 2 weeks after the injury and learns that the
child is still experiencing some sleepiness every day. The neurological exam is normal.
The child and the parent are adamant that the child be allowed to return to play baseball.
What will the nurse practitioner recommend?
ANS- b. Continuation of physical and cognitive rest
1. A 12-year-old child has a recent history of increased thirst and frequent urination. The
child's weight has been in the 95th percentile for several years. A dipstick UA is positive
for glucose, and random plasma glucose is 350 mg/dL. Which test will the primary care pe-
diatric nurse practitioner order to determine the type of diabetes in this child?
ANS - c. Pancreatic autoantibodies
1. A 12-year-old child whose weight and body mass index (BMI) are in the 75th percen-
tile has a diastolic blood pressure that is between the 95th and 99th percentiles for age,
sex, and height on three separate occasions. Which test will be prescribed for this child ini-
tially?
ANS - c. renal function
1. The primary care pediatric nurse practitioner evaluates a child who awoke with a sore
throat and high fever after a nap. The child appears anxious and is sitting on the parent’s
lap with the neck hyperextended. The physical exam reveals stridor, drooling, nasal flar-
ing, and retractions. What will the nurse practitioner do next?
ANS - d. Transport the child to the hospital via emergency medical services.
1. A 16-year-old adolescent female whose body mass index (BMI) is at the 90th percen-
tile reports irregular periods. The primary care pediatric nurse practitioner notes wide-
spread acne on her face and back and an abnormal distribution of facial hair. The nurse
practitioner will evaluate her further based on a suspicion of which diagnosis?
ANS - d. Polycystic ovary syndrome
1. The primary care pediatric nurse practitioner provides primary care for a 4-month-old in-
fant who has a ventricular septal defect (VSD). The infant has been breastfeeding well
but in the past month has dropped from the 20th percentile to the 5th for weight. What
will the nurse practitioner recommend?
ANS - b. Fortifying breast milk to increase the number of calories per ounce
A 3-month-old infant who was previously healthy now has a persistent cough, bilateral lung
crackles, and poor appetite. The primary care pediatric nurse practitioner auscultates a
grade III/VI, low-pitched, holosystolic murmur over the left lower sternal border and pal-
pates the liver at one centimeter below the ribs. What diagnosis is likely?
ANS - d. Ventricular septal defect (VSD)
, 1. The pediatric nurse practitioner provides primary care for a 5-year-old child diagnosed
with cerebral palsy who exhibits athetosis and poor weight gain in spite of receiving high-
calorie formula to supplement intake. The child has had several episodes of pneumonia in
the past year. Which specialty consultation is a priority for this child?
ANS- d. Surgery for possible fundoplication and gastrostomy
The primary care pediatric nurse practitioner is examining a young child who has cerebral
palsy. Which part of the family history raises concerns about potential child maltreatment?
ANS- b. Limited financial resources
Because of their inability to ambulate, children with cerebral palsy should be evaluated for
which nutrients?
ANS- a. Calcium and vitamin D
A child with cerebral palsy receives all nutrition via gastrostomy tube. What will the pri-
mary care pediatric nurse practitioner recommend to promote dental health in this child?
ANS - b. Daily chlorhexidine gluconate rinses
1. A 2-year-old child who has sickle cell anemia (SCA) comes to the clinic with a cough
and a fever of 101.5°C. The child currently takes penicillin V prophylaxis 125 mg orally
twice daily. What will the primary care pediatric nurse practitioner do?
ANS- a. Admit the child to the hospital to evaluate for sepsis.
1. When performing a neurologic exam to assess for meningeal signs in an infant, the
primary care pediatric nurse practitioner will attempt to elicit the Kernig sign by imple-
menting what action?
ANS - b. extending the leg at the knee with the infant supine.
When performing a neurologic exam to assess for meningeal signs in an infant, the pri-
mary care pediatric nurse practitioner will attempt to elicit the Brudzinki sign by imple-
menting what action?
ANS- c. flexing the infant's neck to touch chin to chest.
1. 5 year old child is diagnoses with Atypical Pneumonia and will be treated as an out-
patient. Which antibiotic will the primary care pediatric nurse practitioner prescribe?
ANS- b. Azithromycin
1. The primary care pediatric nurse practitioner (PNP) is examining a 2-week-old infant
and auscultates a wide splitting of S during expiration. What condition may this find-
ing represent?
ANS - a. Atrial septal defect (ASD)
1. A 3-year-old child has had one episode of acute otitis media (AOM) 3 weeks prior
with a normal tympanogram just after treatment with amoxicillin. In the clinic today, the
child has a type B tympanogram, a temperature of 102.5°F, and a bulging tympanic mem-
brane. What will the primary care pediatric nurse practitioner order?
ANS - c. Amoxicillin-clavulanate twice daily
A child who was treated with amoxicillin and then amoxicillin-clavulanate for acute otitis
media (OTM) is seen for follow-up. The primary care pediatric nurse practitioner notes
dull-gray tympanic membranes with a visible air-fluid level. The child is afebrile and without
pain. What is the next course of action?
ANS- c. Monitoring ear fluid levels for 3 months
1. A child is diagnosed with tinea versicolor. What is the correct management of this dis-
order?
a. Application of selenium sulfide 2.5% lotion twice weekly for 2 to 4 weeks
1. A 3-year-old child is brought to the clinic by a parent who reports that the child refuses
to use the right arm after being swung by both arms while playing. The child is sitting with
